title: Renal transplantation and polycystic: surgical considerations.
abstract: BACKGROUND
  The indication and timing of nephrectomy in patients with autosomal dominant polycystic kidney disease (ADPKD) remain controversial, especially in patients who are candidates to renal transplantation (RT). The main surgical options such as unilateral vs. bilateral nephrectomy, nephrectomy before vs. after RT, or simultaneous nephrectomy and transplantation, are herein discussed.
  
  
  OBJECTIVE
  Evidence acquisition of the best surgical management available for ADPKD in the context of kidney transplantation.
  
  
  METHODS
  Systematic literature review in PubMed from 1978 to 2013 was conducted. Articles selected included:randomized controlled trials and cohort studies. Furthermore, well designed ADPKD reviews were considered for this study.
  
  
  RESULTS
  Laparoscopic nephrectomy in ADPKD is a safe procedure with an acceptable complication rate. Unilateral nephrectomy has advantages over the bilateral one regarding the perioperative complication rate. Although the timing of nephrectomy is controversial, it seems that simultaneous nephrectomy and renal transplantation does not increase surgical morbidity neither affect graft survival.
  
  
  CONCLUSIONS
  Simultaneous nephrectomy and RT appears to be an acceptable alternative to conventional two-stage procedure without any increased morbidity, in the context of ADPKD. Furthermore, laparoscopic nephrectomy performed in experienced centres is a safe alternative to conventional approach.
authors.affiliation: Unidad de Trasplante Renal, Servicio de Urología, Fundació Puigvert, Barcelona, España. Electronic address: orodriguez@fundacio-puigvert.es.
authors.forename: O
authors.initials: O
authors.lastname: Rodríguez-Faba
authors.affiliation: Unidad de Trasplante Renal, Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Breda
authors.affiliation: Unidad de Trasplante Renal, Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors.forename: H
authors.initials: H
authors.lastname: Villavicencio
mesh_terms: D006801:Humans; D016030:Kidney Transplantation; D009392:Nephrectomy; D016891:Polycystic Kidney, Autosomal Dominant / Q000601:surgery*
keywords: Autosomal dominant polycystic kidney disease; Nefrectomía; Nephrectomy; Poliquistosis renal autosómica dominante; Transplant; Trasplante